Relationship between maximum walking speed and lower limb muscle strength in hip osteoarthritis with a focus on minimal joint space

Junya Sekita, Athushi Kusaba, Saiji Kondo
Purpose:

This study aimed to investigate the relationship between maximum walking speed and lower limb muscle strength in patients with hip OA, with a focus on MJS.

Methods:

Subjects were 320 female patients with hip OA, including 96 who were admitted to our hospital for surgery and 224 who were discharged with orders for outpatient physical therapy. Exclusion criteria were a history of surgery on the affected hip and an MJS of 0.5 mm in the healthy hip. Maximum walking speed (m/sec), hip ROM (flexion, abduction, extension), pain (VAS), and isometric strength [hip abduction strength (HA), knee extension strength (KE)] on the affected side using a handheld dynamometer (μ-tus F1, anima, Japan) (Nm/kg) were measured. A generalized linear model (logarithmic function) was used to examine the relationship between maximum walking speed and muscle strength with walking speed as the objective variable and muscle strength (HA or KE), hip ROM, pain, MJS, and interaction term [product of muscle strength and MJS (or ROM or pain)] as explanatory variables. If the interaction term was significant, a simple slope analysis was performed as a post-hoc analysis, and a regression coefficient was calculated by dividing subjects into two groups: MJS=0 and MJS>2. 

Results:

None of the interaction terms for ROM and pain were significant, but the interaction term for KE and MJS (product of KE and MJS) was significant (p = 0.039). Muscle strength (HA or KE), age, hip ROM (extension), and pain were factors that significantly influenced walking speed. Simple slope analysis revealed significant regression coefficients in both groups. However, the regression coefficient for MJS=0 (0.381) was higher than that for MJS>2 (0.216), with a tendency for maximum walking speed to rapidly decrease with decreasing muscle strength.

Conclusion(s):

These results suggest that there may be an interaction between KE and MJS on walking speed in patients with hip OA. Moreover, muscle strength (HA or KE), age, hip ROM (extension), and pain are independent factors related to walking speed.

Implications:

A deficit in KE may be associated with a significant decrease in walking speed in end-stage patients. Muscle weakness should be considered a serious problem that needs to be targeted in active training.

Funding acknowledgements:
Funding, acknowledgments: This work was not supported by any funding source.
Keywords:
Hip osteoarthritis
Minimal joint space
Walking speed
Primary topic:
Musculoskeletal: lower limb
Second topic:
Musculoskeletal
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Ethics Committee of Ebina General Hospital，Ethics Committee of Zama General Hospital
Provide the ethics approval number:
207, Za-27
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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